المدونة

What Textbooks to Use in Your Clinical Rotations

I feel that the most fruitful experience I got out of medical school was how selective and precise I’ve become when it comes to where to read what subject. And here comes a list of the references I used for each clinical rotation that really made a huge difference for me and I’ve loved as much as a person could love an inanimate object.

Disclaimer; I managed to score among the highest grades in most if not all my rotations and the one thing I’ve done differently was reading more than I thought I should.

OB/GYN

The two textbooks that are classical for teaching are Ten Teachers and Hacker’s, I’ve read through both and found Hacker to be richer and friendlier. However, the one absolute necessity that would make all the difference for you are the Kaplan videos for OB/GYN and the Kaplan notes on the subject. Dr. Elmar Sakala really makes the subject approachable.

Internal Medicine

I think among the very first textbooks I fell in love with as a medical student was Step up to Medicine it was indeed a total game changer for me. I started reading from it way before I start my clinical rotations and it really does organize your thoughts. Definitely a must for any medical student. However, Kumar and Clark will always stand as the backbone for any IM student (and medical student in general). Whatever is the topic open the index find what you’re looking for read the referred page and the piece of information you have is solid through and through to cut any confusion faced. The issue that most students face with Kumar -including myself- is that we try reading from it very early on in medical school with very limited knowledge and vocabulary which makes it very challenging and demotivating to use again; so later on, when we actually become mature enough to utilize it properly we just don’t because we wrongly labeled it as a tough textbook to read. Give it another chance; trust me no other medical textbook is as precise and as comprehensive.

Pediatrics

Illustrated Textbook of Pediatrics will forever stand as one of the most “amusing” textbooks to study from. Very colorful. Very vivid. And really visual. It truly is illustrated. Everything is put in tables diagrams and logarithms, reading from it really helps you develop a “clinical approach”. Some might argue that Illustrated doesn’t have sufficient details that might be required or become really frustrated with the fact that the UK follows different units for some values that keeping up with numbers gets confusing (I am one of these people) in such case you can always go for Nelson essentials. I personally only went back for it on specific topics that demanded me to know everything there is to know about them for my oral examinations. At the end, and since you’ll soon come to realize how different the pediatric age group is from adults I’d recommend the use of the famous Howasi’s Manual of Clinical Pediatrics for your clinical skills and examination techniques. I wouldn’t recommend anyone to actually study from it, but it is a must when it comes to reviewing and organizing yourself before your clinical tests. Also, a little hint no other textbook has written vaccinations, their types and indications the way Howasi’s does. Everything aside, if I could state the single most important advice regarding your pediatrics rotation; is that if you’re given the option of taking it after completing internal medicine please do. This way you’d at least have perfect examination techniques and an idea about most of the theoretical knowledge apart from hereditary and congenital diseases and God knows you’d need a lot of effort on these alone.

Surgery

For some reason I recall this rotation to be one of the smoothest, probably because I wasn’t required to know how to examine every single system in the body -unlike medicine and pediatrics-. I also remember how intimidated I was at the beginning because I thought my knowledge of anatomy won’t be enough. The truth is learning clinical anatomy is quite simpler than what we learn in our basic years; it could be the repeated exposure or our knowledge having matured enough for concepts to be more graspable but if you’re starting your surgery rotation being as scared as I was rest assured you’ll make it through. The best reference I used in this rotation was definitely Surgical Recall it is a review handbook that’s very precise and to the point of what you as a medical student should know in this level. Everything in it is put in a question and answer format that it helps highlight the significance of each piece of information you are learning. For more elaborate knowledge especially preparing for my oral examination and PBLs I found Mont Reid Surgical Handbookto be quite helpful. It is a very elegant text for you to broaden your knowledge but you can still do just fine with nothing but surgical recall.

Tornoto Notes

I liked to put this Review Textbook on a separate paragraph because it is one of these “study smart” tools that every single medical student should start using early on even prior to their clinical rotations. I personally used it to study for all my minor rotations ENT, Ophthalmology, ER, Psychiatry, Dermatology, Anesthesiology and Orthopedics. I also went through it for some topics in other previously discussed rotations and by God it is very organized, precise and encompassing for the knowledge that a graduating medical school student should obtain. The clinical picture, investigations, management and complications for each disease is listed briefly but efficiently. I am yet to have any opinions on how to prepare for the SMLE (Saudi Medical Licensing Exam) but I know that I will be using it as my main guide. Go get yourself a copy and start reading, because if you’re only starting to use it now you’re already late.

Clinical Skills

I view the argument of which textbook works best here as invalid. The two highly recommended textbooks that almost every single internist and/or clinician would recommend are Macleod’s Clinical Examination and Clinical Examination by Nicholas Talley. Macleod’s was very much preferred by most of my classmates and from my limited insight in the matter I found that due to the fact that it relied more on pictures and focused less on descriptive writing, which made it pretty appropriate for classical teaching. However, personally -with my very humble opinion and expertise- I could rate Talley’s as the best medical textbook ever written. It is very rich literally containing every piece of information you would ever need. It describes examination techniques thoroughly, demonstrates clinical signs vividly and contains a satisfying explanation for them. Reading it does not only give you steps to carrying on your clinical examination but also a reason why for everything you’re doing. And at the end of each system module there is a chapter for clinical correlation that speaks about specific diseases in relation to their clinical presentation, brilliant! I absolutely loved these correlations and I highly recommend you to make sure to read them. There is also a small handbook called Talley’s essentials, I carried that tiny beautiful book in my pocket for a full year. It has all the pros of the big Talley’s except that it is a quicker read and easier to commute. It also contains a lot of tables and images for a small book which makes it even more perfect. We are in a field where, unlike what one might assume, and especially when it comes to clinical examination everything becomes subjected to personal preferences, and at some point, you’d just find yourself really overwhelmed keeping up with what each person wants especially dealing with clinicians you’re meeting for the first time. The one thing that eased my stress at that in my oral tests was me knowing my textbook, and my reference was always Talley’s. So, at the end of the day what information you have really does not matter as long as you know where you got it from and that source is reliable ie a textbook not Google, not what some doctor said in some discussion not what’s put on your lecture slides. If you know your textbook information well I promise you it shows, and I promise you even more you won’t even need to go through the argument of “Oh but that’s what I read in my reference”.

First Aid Step1

At this point of medical school -starting clinical years- you should already be familiar with First Aid Step1. Whenever I am asked what textbook I should read to refresh my knowledge during the summer. Or where should I go to get a quick reminder of basics during clinical rotations I always recommend this book. I am crazy about books -pretty obvious at this point of your reading eh?- and I am also crazy about reading, but I don’t think I’ve read any book more times and as often as I read First Aid -I promise with time the number of times you need to go back reviewing a topic before you master it becomes less frustrating and more habitual-. It gives me what I want in the most efficient way possible. They have all these diagrams and acronyms that make things easier to remember. Also it is very visual and organized. And at the end they have this quick review chapter where it groups presentations with the different diseases they could be found in, a very lovely refresher for your memory.

Pretest Collection

One of the most efficient ways to study that I’ve noticed many of my classmates never even attempting is solving questions. Reading theoretical knowledge alone in medicine is never sufficient, because whether you’re sitting for a theoretical exam or preparing for clinical assessment and/or your future practice you will always be assessed with clinical scenarios where textbook paragraphs might fail to serve you solely. You need to take the knowledge you have and apply it, test it by solving questions. The Pretest series is excellent, I’ve read through some of it and it really helped make a difference.

Q-banks

It doesn’t have to be a question bank for a board you plan on being licensed for. Utilize whatever resource you have. U-world questions are very strong. The Canadian Qbank is also very well explained that some topics seemed better studied from there (make sure to study Asthma management and CAD from there). Check your college question banks and don’t forget to review some SMLE questions as well because even in school your professors would utilize some of these questions to give you a taste of what lays ahead.

Local Books

My life provided me with an opportunity to meet so many people from different backgrounds and nationalities, and the one observation that always excited me that no one studies like an Arab. The westernized science of modern days often blinds us to that truth. To how very peculiar and meticulous our approach to learning is, and because of that I am comfortable saying we make the best teachers. And this is why Arab students tend to excel doing external boards especially on their clinical parts. One of the greatest aids I encountered during my last year were textbooks published by Egyptian universities. These books are perfect for your oral exams they really contain everything you might be asked in a really organized manner. You’d also find hand drawn diagrams and figures that are very cute, but also very demonstrative. I used the following for each major specialty:

Clinical Surgery by Wael Metwalysayed (Hernia and Thyroid are a must to read from here)

Baby Nelson Dr. Mohamed El-Komy (you will not really understand Ricket’s until you read it from here)

Basic Clinical Medicine Dr Mohsen Maher

I literally only read from those at the night of my oral.

Basics are always essential:

I think the best way to study at any point of life is to go back to the basic to really understand what’s going on, the following are the quickest references I managed to find:

Pathophysiology: I always love to go back to Robbin’s however BRS Pathology is direct to the point and could suffice.

Microbiology: First Aid Step1 Microbiology chapter is a masterpiece. Know it by heart.

Pharmacology: I love Lange’s Pharmacology, a very direct to the point kind of textbook, and you can skip the book and just read the Flashcards (hint there is a phone app for them check it out https://play.google.com/store/books/details?id=EYM2DwAAQBAJ). Also, you can go back to the end of each chapter in First Aid to study related drugs.

Clinical Anatomy: Clinical Anatomy for your pocket by Douglas Gould, was the briefest quickest way for me to review my anatomy. It is also very visual and very small it is adorable.

I think this pretty much sums up my past 2 years, and having it written down makes me feel grateful somehow. I hope this was useful, but please remember what textbook you’re comfortable with, and what method of studying you carry are personalized experiences. What works for one person doesn’t necessarily work for others, and because of that try to find your niche in each rotation early on so you thrive appropriately. And remember it is okay to feel frustrated at the beginning of each new endeavor. It is good, it means you’re learning. You’re pushed to your limits to expand and grow.